Booklet six

When anxiety, depression, stress or feeling lack of confidence becomes a problem it can feel very difficult to face things that may once have seemed simple.

For example, after having a baby leaving the house becomes a huge undertaking. Getting everything you need together plus getting you and the baby ready can seem too much to face. It can become easy to decide that you don’t really need to go out. If this starts to become the decision you make most days it will become harder and harder to go out. it’s important to notice anything you’re avoiding doing; perhaps you can relate to some of these things: putting off leaving the house, avoiding speaking to friends or family, repeatedly saying you’ll go to a group next week. Are you avoiding any activities by yourself or with your baby at the moment?

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Think of small ways you could make it easier to do the things you’re avoiding e.g.

• ask someone to help you pack up what you need to go out with your baby
• phone a friend for a chat
• contact your local children centre about activities you could join
• book into a class to help motivate you to go places.

If you’re finding it very frightening to leave the house or do some other activity it would be useful to break the activity down into small, manageable chunks. For example, walking to the local shop. It may have become too difficult to face going to the shop alone with the baby, but breaking this down into smaller parts can help to reduce how frightening it feels.

So the first step may be just to get you and the baby ready to go out and walking to the end of your path or a few houses down the road. You need to practise doing this until you feel relaxed about it. If this feels too much, reduce the task to going out alone and leaving your baby with a friend or relative. The idea is to break it down into small enough stages that you feel comfortable with the one you’re doing before you move on to the next one.

To walk to the local shop with my baby

Possible steps:

1. Go to the end of your path or street with a friend
2. Go to the end of your path or street alone
3. Go to the end of your path or street with your baby
4. Walk two streets with a friend
5. Walk two streets alone
6. Walk two streets with your baby
7. Walk to the shop with a friend
8. Walk to the shop alone
9. Walk to the shop with your baby

It may take a while to feel ready to move on to the next step, the important thing is to keep practising so that you gradually increase your confidence at each step.

Even though this may seem a very frightening thing to have to do, it will help you to build your self-confidence. This in turn will lead to life beginning to feel more manageable as tasks you want to be able to do become less of a threat.

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Put your goal at the top of the list…

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List the steps below…

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(You can add more steps in if you would like to)

Before you begin the steps remember that relaxation exercises may help you to feel more in control of your body. This will be very helpful to you when tackling each step towards your goal. If you start to feel anxious or scared, remember the breathing and relaxation exercises you’ve learnt and use them as you go along. See page 10 in this booklet for the relaxed breathing exercise

By saying out loud what you fear could happen if you do the activity you’re avoiding, you can reduce your anxiety or fear.

You’ll recognise what it is you’re feeling and what is leading to your anxious feelings.

You may find that it doesn’t sound so bad when you’re fully aware of what you’re fearing.

You may notice your fear was based on something unlikely to happen or something you could manage even if it did.

See booklet 4 part 1, ‘Changing your thinking’ for more information on noticing and challenging your thoughts.

Talking positively to yourself – like you might do to a friend – can help you.

Lastly, it’s important to remember that anxious feelings cannot harm you. Often people will begin to rely on things like having a bottle of water handy or always having a mobile phone ready in case they panic. If you find yourself relying on something or someone to enable you to do the things you want to do, you need to learn to do these tasks without relying on the bottle of water or your best friend. You’ll start to learn that you can handle the situation yourself, increasing your confidence even further.

Make sure you give yourself a ‘well done’ for every step you take. At first when you challenge yourself to face a situation your anxiety levels may rise – but they will then fall.

Panic attacks and avoidance

• Panic and anxiety can cause bodily feelings such as dizziness, tingling limbs, racing heart and sweating.
• The bodily feelings can lead to frightening thoughts about what might be happening.
• Anxiety and panic are a natural reaction to stress which has become exaggerated.
• Panic attacks will pass and they’re not harmful. You can learn to overcome anxiety and panic attacks
• Through relaxation, thought challenging and facing the situations you find fearful.
• Practise relaxation methods.

Breathing

If you’re feeling stressed and anxious it’s likely you’ll be breathing with short, sharp breaths that only use part of your lungs. By learning to breathe more deeply your breathing will start to slow down, bringing a feeling of calmness and control.

First ask yourself how stressed /anxious/angry you feel. Rate it from 0-10 with 0 as calm.

Hold your breath for a count of 3. This disrupts your unhelpful breathing pattern. Try to breathe in through your nose. Imagine you’ve a balloon in your stomach that you need to fill with the air. You don’t want your chest to rise higher (this indicates more shallow breathing). You want your stomach to rise as this shows you’re doing deep abdominal breathing.

Place one hand on your chest and one hand on your stomach – you should see the hand on your stomach rising most. Now breathe in for a count of 3, hold the breath for a count of 2 then breathe out through your nose or mouth for a count of 4.

Repeat.

After repeating 3 times rate how you feel again, between 0-10. Are you calmer? If not repeat again and re-rate, continue to do so until you feel a positive effect.

If you’re beginning to feel better decide if you need to repeat again for more benefit.

It’s possible that slowing your breathing will make you feel dizzy. This is simply a result of you getting more oxygen than you had before.

Ultimately learning to slow your breathing will enable you to feel physically and mentally more calm and relaxed.

Problem solving

Some problems can seem impossible to cope with. For example, financial worries. Spending a bit of time thinking about the possible solutions to the problem can help you to feel more hopeful and in control.

Problem solving can be done in 4 steps

1. Identify what it is that is troubling you: e.g. Not having enough money to pay the telephone bill

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2. Think of as many solutions as you can, be as creative as possible:

e.g. Make a weekly budget plan to identify where savings can be made, sell something, get a part time job, buy a lottery ticket, double check any benefits you may be entitled to, ask a family member or a friend for help, go to Citizen’s Advice Bureau…

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3. Put the solutions in order, putting the one you think you could do at the top and the most unlikely at the bottom. Use this list to decide which of the solutions you’re going to try.

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4. Identify small steps that will help you put that solution into action e.g.

1. Find the phone number for the benefits agency.
2. Phone the agency and ask for a support worker to advise you.
3. Visit the agency and get any forms that need filling in
4. Ask an advisor or friend to help you.
5. Take the forms in to the agency.

On the next page write down your own steps which might help you to gradually solve your problem.

While these steps may seem very small, it allows you to make a task that seems huge appear more manageable. If you plan to achieve one small step each day the big problem gradually gets broken down.

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Talking about your feelings to someone you trust can reduce the impact they have on you. When was the last time you told someone how you’re feeling? Make an opportunity to talk to a friend, family member or your partner in the next week. If you find it difficult to talk to the people around you, ask your GP or health visiting team about free counselling or talking therapy from the NHS.

Summary

Taking action to problem solve …

• Plan activities into your day that will help you feel
• Breaking down your problems into manageable steps will help you overcome them and feel more able to cope.
• Work out what might stop you from doing a step and what you can do about this.
• Talk to someone when things get difficult.